Individual provider Active NPI

Sandria Joan Foster, APRN

  • Gerontology Nurse Practitioner
  • Ocoee, FL
National Provider Identifier
1871863597
Registry record updated Jun 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11001462 Issued in FL
Practice address
3343 Atmore Ter
Ocoee, FL 34761-4442
Phone
(407) 205-5510
Fax
(407) 703-4451
NPI assigned
Jan 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11001462 FL Primary
Registered Nurse 163W00000X 1136932 FL
Gerontology Registered Nurse 163WG0600X 1136932 FL

Addresses

Primary practice location

3343 Atmore Ter
Ocoee, FL 34761-4442

Mailing address

1746 E Silver Star Rd
Suite 243
Ocoee, FL 34761-7014
Phone (407) 802-6766

Other practice location 1

1746 E Silver Star Rd
Suite 243
Ocoee, FL 34761-7014
Phone (407) 802-6766

Other identifiers 2

IdentifierTypeStateIssuer
692190696 96MedicaidFL
692190696 98MedicaidFL

Other names 1

  • Miss Sandria Joan Baker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1136932FLMDGerontology Registered Nurse
11001462FLMDGerontology Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1871863597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1746 E SILVER STAR RD",
            "address_2": "SUITE 243",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347617014",
            "telephone_number": "407-802-6766",
            "fax_number": "407-362-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3343 ATMORE TER",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347614442",
            "telephone_number": "407-205-5510",
            "fax_number": "407-703-4451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1746 E Silver Star Rd",
            "address_2": "Suite 243",
            "address_purpose": "LOCATION",
            "city": "Ocoee",
            "state": "FL",
            "postal_code": "347617014",
            "country_code": "US",
            "telephone_number": "407-802-6766",
            "fax_number": "407-362-1761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "SANDRIA",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11001462",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "1136932",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "FL",
            "license": "1136932",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692190696 96",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692190696 98",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRIA",
            "last_name": "BAKER",
            "middle_name": "JOAN",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.